Ottoman psychiatric institutions developed gradually over the long nineteenth century in the spaces of early modern Ottoman imperial hospitals located within charitable complexes. These imperial hospitals were altered to accommodate the increasingly “medicalized” needs of mental patients, in tandem with the emerging field of psychiatry during this time. Located at the intersection of architectural and medical history, this article discusses evolving treatments of madness by focusing on Istanbul Toptaşı Asylum that was used as the state mental hospital between 1873 and 1924. The article explores the spatial interventions carried out in the asylum as they affected the daily routines of its occupants, patients, doctors, and staff, which were considered crucial components of the “healing process” in the nineteenth century. The reorganization of the asylum’s space and time, as mundane as they might seem, offers novel insights into the functioning of the asylum, and, in turn, into the theory and practice of Ottoman psychiatry.